梅毒患者住院费用及其影响因素的通径分析

Research on the Hospitalization Expenses and Influencing Factors of Syphilis Patients Based on Pathway Analysis

目的研究梅毒住院患者次均住院费用现状并分析其影响因素,为合理有效率控制医院住院费用上涨、减轻患者就医负担提供科学性建议。方法收集广东省某三级皮肤病专科医院2015年1月1日-2019年12月31日538例梅毒住院患者病例资料,运用描述性分析、单因素t检验、通径分析及中介效应检验等方法对梅毒住院患者住院费用基本状况进行描述,并探究各影响因素与住院费用间相关关系。结果梅毒患者平均住院费4931.33元,平均住院天数5.99天,通径分析显示住院天数(β=0.538,P<0.001)、是否使用抗菌药物(β=0.227,P=0.006)、是否医保(β=0.147,P<0.001)、是否手术(β=0.223,P<0.001)会直接影响总费用,其中性别(β=0.029,P=0.005)、是否使用抗菌药物(β=0.417,P<0.001)、是否手术(β=-0.036,P=0.003)通过影响住院天数间接影响住院费用。结论影响住院费用的因素主要是住院天数、是否使用抗菌药物、是否手术。

Objectives To explore the current status of the average hospitalization expenses of syphilis inpatients and analyze its influencing factors,so as to provide scientific suggestions for rationally and efficiently controlling the increase in hospitalization expenses and reducing the burden on patients.Methods To collect the data of 538inpatients with syphilis in a tertiary dermatology hospital in Guangdong Province from January 1st,2015 to December 31st,2019,and used descriptive analysis,t test,path analysis,and intermediary effect test to evaluate the basic status of hospitalization expenses for syphilis inpatients,then described and explored the relationship between various influencing factors and hospitalization costs.Results The average hospitalization fee for syphilis patients was 4931.33 yuan,and the average length of stay was 5.99 days.Path analysis shows that the length of stay(β=0.538,P<0.001),whether antimicrobial drugs were used(β=0.227,P=0.006),whether medical insurance(β=0.147,P<0.001),whether or not surgery(β=0.223,P<0.001),would directly affect the total cost,including gender(β=0.029,P=0.005),whether antimicrobial drugs were used(β=0.417,P<0.001),whether surgery(β=-0.036,P=0.003),pass affected the length of stay in hospital and indirectly affected the cost of hospitalization.Conclusions It was recommended that medical institutions standardize the management methods for the clinical application of antibacterial drugs.In addition,we should strengthen the preaching of syphilis prevention and treatment,focusing on the discovery of primary syphilis,early detection and early treatment,and combination of prevention and treatment.Furthermore,through the establishment of an information-based medical insurance cost control decision support system,the organic integration of medical insurance payment methods and the hospital's performance appraisal system would effectively control the hospitalization expenses of syphilis patients and have the ability to reduce the economic burden of patients'medication and hospitalization.